An American transplant. The Rockefeller Foundation and Peking Union Medical College

century on. "For the first time doctors found themselves able to obtain significant results, and recognizing that these could lead to fame and renown, many more doctors began to attach importance to clinical work and, consequently, to the hygiene of hospitals." The majority then preferred the pavilion plan. While cited, Florence Nightingale is upstaged. A further point is made that as soon as germs had been identified and sterilization introduced, doctors saw no advantage in the pavilion form over others, buildings being no longer considered instruments of cure. They advocated the less expensive high-rise hospitals and did what they could to siphon saved funds into medical technology and research. Nurses, meanwhile, clung to the pavilion for its ease of nursing supervision. Andrew Scull (professor of sociology) traces the Victorian lunatic asylum, "a convenient place to get rid of inconvenient people," from its idealistic beginnings in the early nineteenth century, when it was hoped that real cures might come from diagnosis, segregation, and classification of what had been the undifferentiated mad, homogenized within the general population. But the cure rate remained at about eight per cent, and well-meaning but ever larger asylums filled up with a backlog of incurables. What had been effective moral treatment for thirty patients at the York Retreat proved unworkable in state institutions housing two thousand. The plan of Claybury County Asylum speaks for itself, incidentally illustrating why the word "asylum", originally a refuge as in the words "grant asylum", was debased to "asylum" meaning "loony bin". The endless Italianate facade of Colney Hatch Lunatic Asylum, 1851, reinforces the sad text, as does an elevation of pavilions at Leavesden Woodside and Caterham, 1868, for the "efficient storage for pauper lunatics". "It is in respect to the very evils these institutions were designed to remedy that they are themselves conspicuously defective." Scull grimly foresees that, overflowing with patients to this very day, the obsolete buildings will not easily be obliterated. He does not refer to a considerable dent in mental hospitalization recently made by psychotropic drugs. This beautiful book can be entered from many professional disciplines. Once within, professionals will enjoy a fresh breath of air if they wander across to the unknown areas: for physicians and medical historians this would mean to consider, perhaps for the first time, the development of the restaurant, the vacation house, or indeed architecture itself, the built environment. Grace Goldin Swarthmore, Pa., U.S.A.